Obamacare, or as the more erudite among us call it, the Patient Protection and Affordable Care Act will take full effect in theory this coming January of 2014. The only saving grace is that Secretary of Health and Human Services Kathleen Sebelius is well behind in formulating all of the regulations which are demanded within the thousand plus pages of the legislation. Of course the ever diligent IRS is well on their way to hiring the eventual 16,500 additional agents to enforce the taxation related to the national healthcare system. There is a feeling that something is basically wrong with a healthcare system which requires the government to hire so many additional tax enforcement agents while not having any proposals to hire a single additional doctor. Unfortunately, the lack of hiring of healthcare workers is just the tip of the proverbial iceberg of the irregularities surrounding the differences between promises and the reality of Obamacare.
As noted above, the lack of hiring of even a single additional doctor is troubling and only gets worse when you add that there has been no hiring of a single additional physician’s assistant, nurse, healthcare technician, orderly or other hospital worker. Making things far more ominous has been the results of numerous polls of physicians which on average have presented results indicating that anywhere from 35% to a startling 65% of those polled were seriously considering hanging up their stethoscopes rather than practice under the rules stipulated in Obamacare. If even just 10% of physicians hang up their stethoscopes the backlog of patients will be an insurmountable problem within the first year. The real problem is that it has been estimated that there could be as many as 25% increase in caseload added to the healthcare system, and that is one of the more conservative estimates. How the healthcare system will stay astride a measurably significant increase in caseload with a reduction in the available physicians to treat said patients is definitely going to present a serious problem. Either physicians will need to increase the rate at which patients are treated or add hours to each physician’s day or longer their workweek. I would not want to take any bet that physicians would face burnout in short order, simply retire or start to treat patients outside of the restrictions and requirements of Obamacare. The last of these choices would place them on the wrong side of Federal Law in short order and they would likely be closed down if not incarcerated. The government is not known for their sense of humor nor taking kindly to those who wish to operate outside their imposed systems.
Another realization which has been admitted by the administration and those who have investigated every letter of the Obamacare legislation is that there really will be panels which will decide who gets what levels of care and whether or not any patient will receive any care on some prorates cost-benefit analysis. The one name for the system that will be utilized has been referred to as the “Complete Lives System” which limits severely any care provided at either end of the age spectrum. Such a system if implemented would have some groups of voters up in arms in a very short time. Senior citizens would be up in arms as soon as they realized that they would not be receiving any medical procedures which carried with them anything beyond a minimal monetary outlay. That would mean no hip replacements, no cancer treatments, no surgeries of any variety, and some highly active and angry set of people who vote regularly, have the time to demonstrate and would engender sympathy from the general public, especially since most of us have parents who will someday be in this category. And the ire of the senior citizens would pale in comparison when parents are informed that their child is not worthy of any expensive procedures as they are not of sufficient age. The younger the child the less expense the care given the Complete Lives System is willing to allocate. Imagine the parents of a child born with what is now a regularly treated hearts defect commonly known as Blue Baby Syndrome. Such surgery on a newborn would fall outside of restriction on infants as they are not considered readily likely to be a cost benefit as their work-life is still a good twenty years away and so many possible complications could prevent their ever becoming a producing member of society. Another category of people who would receive next to no care would be the chronically ill be it a physical illness such as diabetes or a mental disorder as in both instances the person is considered more expensive to care for and a poor investment of medical expenditures. Yes, that’s right, in the Complete Lives System Stephen Hawking would never have become a physicist as he would have been deemed a bad health risk that would not have been likely to produce a positive financial outcome.
The worst problem which comes consequential to Obamacare is that it takes approximately 17% of the United States economy and makes it into a government program. Since investigations of numerous government programs has produced a result that the Federal Government must take in five dollars for every three they intend to spend, some of these researchers have found returns far worse where some departments would be fortunate to get one dollar for every five dollars collected. Even using the most optimistic return on tax dollars of three out of five dollars returned, then this will make the 17% of GDP into over one quarter of GDP at slightly over 28% of GDP. Add this significant quantity of the United States economy into the mix of other Federal expenditures and all government would then be responsible for well over half of GDP. Many economists will tell that at such size the government becomes unsustainable. Europe is currently figuring out that they can no longer continue to provide the services at current levels even with their tax rates at levels well above anywhere currently in the United States. Maybe all those who were labeled alarmists or conspiracy theorists were actually giving an accurate accounting of the unavoidable results of Obamacare would lead. All of these problems which will result from Obamacare do not take into consideration the unseen unintended consequences which seem to accompany every governmental effort. The only additional question that remains is which will compel the citizens to rebel first, the poor resulting quality of care under Obamacare or the ever spiraling upward taxes which never seem to prevent huge deficits because of Obamacare. Either way, Obamacare may just turn out to be the largest failure of the Federal Government, quite an accomplishment after the other SNAFUs we have managed to live with thus far.
Beyond the Cusp